From Behind the ‘Paywall’ of The Times:

(I’ll remove it if anyone objects.)

Theodore Dalrymple shows us that there is much scope for sadism in the role of prison doctor and how he himself derived much pleasure from this aspect of his role. I suspect that it was almost as much fun as having patients “injected in the buttock” in his primary role as a consultant psychiatrist at an inner-city general hospital in Birmingham. Note that he and the sycophants who surround him have stopped calling it a slum.

Weak doctors leave prisoners hooked on prescription drugs

Theodore Dalrymple: Former Prison Doctor.

The Chief Inspector of Prisons has reported that abuse of prescription drugs in prisons has increased to an alarming extent. I am surprised only that it took him this long to discover it.

By the time I left the prison service after 15 years, I had formulated a rough-and-ready rule: if a prisoner was willing to take medicine, he didn’t need it; and if he wasn’t willing to take it, he did. There were exceptions, of course; but every prison doctor must remember that medication, especially if it has a psychological effect, is coin of the realm in prison. A pill may change hands many times before it is actually taken.

There are several reasons for over-prescription of drugs in prison. Many prisoners arrive already on prescription drugs they don’t need. A high percentage of doctors have been assaulted or threatened by patients in the past 12 months, an even higher percentage in the areas from which most prisoners are likely to come, so doctors are inclined to prescribe potentially aggressive patients what they demand rather than what they need, which in most cases is nothing.

Doctors in prisons feel obliged to continue these prescriptions, partly because doctors do not like to stop other doctors’ prescriptions without deeper knowledge of the patient, and partly because it is easier. To stop a prescription is to court an unpleasant scene, in which the prisoner will accuse the doctor of negligence or worse, threaten to complain, shout and even menace. Not a few prisoners told me that if I did not prescribe the valium they wanted, they would attack or kill a prisoner or a prison officer.

“Let me give you a word of advice,” I would reply.

“What?”

“Don’t.”

They would look in my eye and see that I was not to be moved. Some would laugh, others would be angry with the anger of the justly accused. But it took experience and firmness to resist their blackmail.

Experience and firmness of character were just the qualities the NHS did not seek in its prison doctors when it took over healthcare from the Prison Medical Service. The prescription of codeine and other sought-after drugs shot up without the slightest medical reason.

In the modern world, compassion easily slides into sentimentality and moral cowardice. Doctors like to think that their patients are telling the truth. Prisoners are often not like that; but inexperienced and weak doctors are reluctant to recognise it or be “judgmental”, the worst moral failing in the modern world. And so it is Goldilocks against Genghis Khan.

Face it, Doc, your specialism is about as scientific as witch finding and your methods as sophisticated as the ducking stool.

Addendum: (11.2.2013) In 1994 in an article (an op-ed piece) in The City Journal (an American publication) entitled The Knife Went In  Dalrymple writes: ‘As a doctor who sees patients in a prison once or twice a week, I am fascinated by prisoners’ use of the passive mood and other modes of speech that are supposed to indicate their helplessness. They describe themselves as the marionettes of happenstance.’  Once or twice a week?  Interesting.

 

Sylvia Plath was given ECT without anaesthetic shortly before her first nervous breakdown and suicide attempt. Collective guilt, anyone? Think about it people.

Karma In Action

Telling Stories

Tracy Chapman

There is fiction in the space between
The lines on your page of memories
Write it down but it doesn’t mean
You’re not just telling stories
There is fiction in the space between
You and me

There is fiction in the space between
You and reality
You will do and say anything
To make your everyday life
Seem less mundane
There is fiction in the space between
You and me

There’s a science fiction in the space between
You and me
A fabrication of a grand scheme
where I am the scary monster
I eat the city as I leave the scene
In my spaceship I am laughing
In your remembrance of your bad dream
There’s no one but you standing

Leave the pity and the blame
For the ones who do not speak
You write the words to get respect and compassion
And for posterity
You write the words and make believe
There is truth in the space between

There is fiction in the space between
You and everybody
Give us all what we need
Give us one more sad sordid story
But in the fiction of the space between
Sometimes a lie is the best thing
Sometimes a lie is the best thing

I stumbled across this the other day and then I stumbled across this:

I had an early intimation of the attractions of evil when I was quite small. As a boy, I went to a lot of football matches and was enthusiastic about them in a way that I now find very difficult to understand. Anyhow, there was a cup match which I deemed it of supreme importance that I should attend, and as the tickets went on sale well in advance, I took myself off to the stadium and joined a very long queue. I was about eleven years old at the time.

In front of me in the queue was a group of young men. Going along the queue was an old blind beggar, accompanied by a child with a cap into which donors could put their coins. The old man had an accordion and was singing ‘The Man Who Broke the Bank of Monte Carlo’. As he approached the young men they turned up the volume of the transistor radio that they had with them to drown out the old man’s song, laughing as they did so. The poor old man was bewildered, and walked away as if confused and frightened.

I have never forgotten that little incident, and it has haunted me – not continuously, I hasten to add – ever since. The pleasure those young men took in taunting the old man, and laughing at him, taught me that the human heart is not invariably good; that there is a lot of fun in cruelty. But it also taught me something else.

I did nothing to defend that old man. Of course, it would have been unreasonable, as I now realise, to expect an eleven year-old boy to go and tackle a lot of seventeen year-olds, or however old they were; discretion in this case really was the better part of valour. But I knew then, straight away, that I failed to assist the man from cowardice and for no other reason; and furthermore, no one else in the queue intervened either. As Edmund Burke put it, or is supposed to have put it (there is a brilliant essay on the internet pointing out that there is no source of this famous quote), ‘All that is necessary for evil to triumph is for good men to do nothing’.

Sometimes I think that maybe, just maybe, there really is a God.

Addendum: I’d like to remind readers of The Wall Street Journal of the tragic case of Kitty Genovese.

Addendum II:  I must say I can do nothing but agree with the commenter writing here who asserts that, ‘I’ve not read the article, but most of the comments. I find the ‘was ever thus’ mentality never ceases to amaze me.’

Indeed.  We used to hang, draw and quarter traitors.  In these more enlightened times we just throw food at them.  Now that’s what I call progress.

Dug This Up

(from my last admission in my baby black notebook. Don’t expect coherence.)

Extract from Hospital Diary

In hospital. Feels like a prison. The staff do their best but with very limited resources. They work long shifts: twelve hours. This is why I don’t want to sound ungrateful. Much of what happens is beyond their control. Everything, it seems, is in the hands of the bean counters.

When I was in hospital a few years ago I was on a brand new, plush ward. They even had duvets. This was a state of the art ward. A model on which all other wards should be based. They spent millions of pounds on this ward only to close it down a couple of years later. That leaves two acute psychiatric ward to cover an entire city and its surrounding areas.

This feels punitive: something they are prone to do to people even suspected of self harming. Yet they never seem to adopt this attitude to those who harm others. It seems that people who harm others are feared and respected by the staff and patients alike. Those who harm themselves are despised and rejected. They are accused of being manipulative attention seekers. These labels never seem to be attached to those who harm others. Funny that because there’s nothing more ‘manipulative and attention seeking’ than punching someone in the mouth. So, as always, the bullies emerge triumphant.

And in the long term pampering those who harm others doesn’t just make life difficult for their fellow patients; it also makes life difficult for the staff because it encourages others to emulate them, elbowing their way to the front, at the expense of other less volatile but more vulnerable patients. And one day they may turn on the staff themselves.

The system is set up to reward bullying just as it is school and in other institutions. The timid are given little time or acknowledged. Just like the outside world. And my anger is not directed at the staff. They are foot soldiers. It is the Generals who issue the orders.

There Really Is Nothing New Under the Sun

‘Young mother down at Smithfield
5 am, looking for food for her kids
In her arms she holds three cold babies
And the first word that they learned was “please”

These are dangerous days
To say what you feel is to dig your own grave
“Remember what I told you
If you were of the world they would love you”‘

Black Boys On Mopeds, Sinead O’Connor

In the early nineties I was taking my A Levels and living with my parents in a 1930s semi detached pebble dashed house in the suburbs of Birmingham.  I also had some pretty severe psychiatric problems (an eating disorder, depression etcetera).  The house in which we lived was one of those ex-council houses that so many people enjoy sneering at, forgetting that their inhabitants are only there because they were desperate to be a part of Maggie Thatcher’s ‘Home Owning Democracy’.

Most of the neighbours were ‘decent’, reasonable, hard-working people but there was a large family whose children pretty much terrorized the entire street.  They would smash the wind screens of cars, verbally intimidate people as they walked past, attack the vulnerable.  I was sexually assaulted by one of them.  They targeted our next door neighbour.  He was a retired, elderly gentleman living in the upstairs flat of the house next door.  His garden was at the front of the house.  He worked hard on it, planting flowers and vegetables.  Eventually he gave up because these kids would trespass on his land and simply wreck it.  My father tried to intervene on several occasions but eventually he gave up too.  The reason?  On the final occasion the eldest ‘child’, a boy who was taller than he was, shoved my father.  My father, reacting instinctively, shoved him back. The police were called and my father was told that if he did anything like that again then he would be the one who would be prosecuted.

WTF are people getting out of pretending that this is anything new?